| Doctor Name: | EVA BLANCO |
| NPI Number: | 1285018838 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP128526 |
| Business Practice Address: | 2790 Pharmacy Rd Rio Grande City, TX - 785826546 |
| Business Phone Number: | 9564877561 |
| Business Fax Number: | 9564870097 |
| Mailing Address: | 2790 Pharmacy Rd, RIO GRANDE CITY |
| State: | TX |
| Postal Code: | 785826546 |
| Phone Number: | 9564877561 |
| Fax Number: | 9564870097 |
| NPI Enumeration Date: | 07/14/2015 |
| NPI Last Update Date: | 07/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP128526 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |